#494 C. diff, Diarrhea, the Microbiome, and New Therapies with Dr. Cynthia Sears. Live from Johns Hopkins Grand Rounds
Dominate C. diff! Learn to distinguish colonization from infection, select first-line therapies, and counsel patients on recurrence prevention and microbiome recovery. We’re joined by IDSA past president and expert on foodborne and intestinal infections, Dr. Cindy Sears (Johns Hopkins University) for a comprehensive update on Clostridioides difficile (C. diff, Cdiff, CDAD, CDI).
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
00:00 Intro
03:00 Guest bio and hobby
04:25 Case of Charles Fleur Fontaine
06:00 Risk factors and epidemiology
08:00 Antibiotic hierarchy of risk
10:00 Diagnosis, testing strategies
14:00 Defining severity
17:30 Treatment options
20:00 Microbiome recovery strategies
24:00 Probiotics and postbiotics
27:00 Infection control counseling
30:00 C. diff and colon cancer
32:00 Recurrent C. diff strategies
35:00 Why some FMT and bezlotoxumab were discontinued
38:00 Microbiota replacement therapies
43:00 Prophylaxis strategies
45:00 Future therapies and ongoing research
47:00 Audience Q&A
52:00 Outro
Credits
Written and Produced by: Matthew Watto, MD, FACP
Cover Art and Infographic by:
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Sai S Achi MD,MBA,FACP
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Cynthia Sears MD
Disclosures
Dr. Sears reports no relevant financial disclosures. Dr. Williams financial relationships disclosed include a Merck grant or research support. This relationship has not ended.
Sponsor: Mint Mobile
This year, skip breaking a sweat AND breaking the bank. Get this new customer offer and your 3-month Unlimited wireless plan for just 15 bucks a month at mintmobile.com/CURB
Sponsor: Panacea Financial
Let Panacea Financial take the financial stress off your plate,so you can get back to doing what matters most. Visit panaceafinancial.com
Sponsor: FIGS
Get15% off your first order at wearfigs.com with the code FIGSRX
--------
57:50
--------
57:50
Bonus: Hypermobility Q&A with Bendy Bodies Dr. Linda Bluestein
In this special bonus episode, Dr. Linda Blustein (Bendy Bodies https://bit.ly/m/BendyBodies) addresses listener questions about Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders.
00:00 – Introduction
00:59 – Can PCPs diagnose hEDS without a geneticist?
03:19 – Limitations of the Beighton Score
05:40 – 2017 hEDS criteria & upcoming revisions
10:29 – How to find a knowledgeable provider
12:52 – SVT vs POTS in a patient with EDS family history
19:53 – How to ask your provider if they’re comfortable treating dysautonomia
22:17 – MTHFR variants and hEDS
29:23 – Celiac, gluten sensitivity & EDS
31:48 – Food allergy vs sensitivity testing
34:11 – Lipoedema and hypermobility
39:00 – LDN, Ketotifen, and Cromolyn
43:41 – Medication sensitivity in EDS/POTS/MCAS patients
45:47 – Wrap up and resources
FIGS
Get 15% off your first order at wear figs.com with the code FIGSRX
Locumstory
Locumstory.com is simply a free, unbiased educational resource about locum tenens
Grammarly
Download Grammarly for free at Grammarly.com/PODCAST
--------
51:22
--------
51:22
REBOOT: #452 NAFLD/MASLD with Dr. Elliot Tapper
We have a classic Curbsiders episode for you. Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications.
--------
1:14:01
--------
1:14:01
#493: Joint Pain in Older Adults with Dr. Una Makris
An age-friendly approach to arthralgias.
Attack arthralgias with ease! Learn how to evaluate and manage common joint complaints in older adults. We’re joined by Dr Una Makris, @unamakris.bsky.social (UT Southwestern).
Claim CME for this episode at curbsiders.vcuhealth.org!
Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME
Show Segments
Intro
Case 1 from Kashlak
General approach to joint pain in older adults
Diagnosing osteoarthritis
Management of osteoarthritis in older adults
Non-pharmacological interventions
Pharmacological interventions: topicals, orals, injectables
When to refer for joint replacement
Case 2 from Kashlak
Diagnosis of Late onset rheumatoid arthritis (LORA)
Differential Diagnosis and Distinguishing features
Lab work/Imaging
When to refer to rheumatology
Approach to managing LORA
The 5Ms framework
Initial treatment with glucocorticoids
Ageism as a driver of undertreatment in older adults
Treating to target
Key takeaways
Outro
Credits
Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD
Cover Art and Infographic: Leah Witt, MD
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto, MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Dr. Una Makris
Disclosures
Dr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Sponsor: Heart of Care
If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts.
Sponsor: FIGS
Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX.
--------
1:13:56
--------
1:13:56
REBOOT: #454 Kidney Boy on Managing Diabetes and Hypertension in CKD
Here is a classic Curbsiders episode with one of our favourite guests of all time, Dr Joel Topf.
Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.
Finerenone is FDA approved for managing CKD in patients with diabetes. **Update as of July 2025: The non-steroidal mineralocorticoid recepter antagonist, finerenone is now FDA approved to treat heart failure with LVEF at or above 40% based on results of the FINEARTS-HF trial. **
Claim CME for this episode at curbsiders.vcuhealth.org!
Heart of Care
If you care about patient safety, team performance, and building a culture of readiness, subscribe to In the Heart of Care. Available now, wherever you get your podcasts.
Quince
Go to Quince.com/curb for free shipping on your order and three hundred and sixty-five -day returns.
Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice-changing knowledge, and bad puns. Doctors Matthew Watto, Paul Williams, and friends (a national network of students, residents, and clinician-educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high-value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.